Ccs General Quiz IV

As long as she is honest about her current credential she may ethically apply for the position. She may be told that she is not applicable until she gets her RHIA. Honesty and transparency are key.

Radiculopathy refers to a condition where there is compression or irritation of a nerve root, usually in the spine. This can result in radiating pain, which means that the pain travels from the site of the nerve compression or irritation to other parts of the body supplied by that nerve. Therefore, when experiencing radiating pain, it is likely that the cause is radiculopathy.

CAN BE BILLED SEPARATELY

CPR 

Endotracheal intubation 

Central line placement 

Intraosseous placement

Tube thoracostomy

Temporary transvenous pacemaker 

Electrocardiogram - routine ECG with at least 12 leads; interpretation and report only

Elective electrical cardioversion

 

When protected health information has been disclosed inappropriately, it is referred to as a breach. A breach occurs when there is an unauthorized release or access to sensitive health information, compromising the privacy and security of the individual's personal health data. This term is commonly used in the context of healthcare and data protection regulations to describe situations where there has been a violation of privacy rules and regulations.

PHI stands for Protected Health Information. This term refers to any individually identifiable health information that is created, received, maintained or transmitted by a covered entity. It includes any information about a person's past, present or future physical or mental health, as well as any healthcare services provided to them. Protected Health Information is subject to strict privacy and security regulations under the Health Insurance Portability and Accountability Act (HIPAA) to ensure the confidentiality and integrity of patients' health information.

The CMS-1450 form (aka UB-04 at present) can be used by an institutional provider to bill a Medicare fiscal intermediary (FI) when a provider qualifies for a waiver from the Administrative Simplification Compliance Act (ASCA) requirement for electronic submission of claims. The UB04 claim form is used to submit claims for inpatient AND outpatient services by institutional facilities (for example, outpatient departments, Rural Health Clinics, chronic dialysis and Adult Day Health Care).



CMS 1500 is used only by the physicians, not hospitals (non-institution based), or supplier to bill Medicare carriers and durable medical equipment regional carriers (DMERCs) when a provider qualifies for a waiver from the Administrative Simplification Compliance Act (ASCA) requirement for electronic submission of claims. It is also used for billing of some Medicaid State Agencies. Please contact your Medicaid State Agency for more details.

A bilateral salpingectomy is a surgical procedure that involves the removal of both fallopian tubes. This procedure is typically performed for various reasons, including sterilization, treatment of certain gynecological conditions, or as a preventive measure for individuals at high risk of developing ovarian cancer. By removing the fallopian tubes, the procedure effectively eliminates the possibility of fertilization and prevents the eggs from reaching the uterus, thus providing a permanent form of contraception.

Stage 3 and 4 ulcers are on the HAC list

According to Medicare, a major surgery has a global period of 90 days, and a minor surgery has a global period of either 10 or 0 days. Thus, the time frame of, not the complexity of, the surgery determines whether a surgery is major or minor.

Authorization must be completed in order to permit a specific disclosure of protected health information. Consent refers to the general permission given by a patient for the use and disclosure of their health information, while authorization is a more specific and detailed form that allows the release of protected health information for a particular purpose. Access refers to the ability of individuals to view and obtain their own health information. Redisclosure refers to the sharing of health information that has already been disclosed once. Therefore, authorization is the correct form to be completed for a specific disclosure of protected health information.

The Uniform Hospital Discharge Data Set, which is referred to as the 'UHDDS,' is the core data set for inpatient admissions. The data is collected on inpatient hospital discharges for Medicare and Medicaid programs. Much of the required information can be located on the patient's face sheet.

The correct answer is bursae and ligaments because the anterior cruciate ligament is a ligament located in the knee joint. Ligaments are part of the bursae and ligaments body system, which includes the connective tissues that support and stabilize joints. Therefore, when coding the repair of the anterior cruciate ligament, it would be classified under the bursae and ligaments body system.

If a listing for ankle does not exist, the foot body part is used. This implies that when referring to a specific body part in a listing or categorization, if there is no separate category for the ankle, it is grouped under the foot category. This suggests that the ankle is considered a part of the foot and is not distinguished as a separate body part in this particular context.

Relative Value Units. The CASE mix index is a relative value unit (DRG) assigned for a period of time

Other Diagnosis Coexist at the time of admission, that develop subsequently, or that affect the treatment received or the length of stay

Secondary Diagnosis Receives clinical evaluation, therapeutic treatment, further evaluation, extends the length of stay, or increases nursing monitoring and care



The Uniform Hospital Discharge Data Set, which is referred to as the 'UHDDS,' is the core data set for inpatient admissions. The data is collected on inpatient hospital discharges for Medicare and Medicaid programs. Much of the required information can be located on the patient's face sheet.

When the question tells you that the patient has died, it is important to be suspicious because certain conditions receive a CC/MCC only if the patient is discharged alive. This means that if the patient has died, these conditions may not be applicable or relevant in the context of the question. Therefore, the statement "True" is correct in this case.

Cyanosis is the bluish discoloration of the skin or mucous membranes due to a lack of oxygen in the blood. It is a symptom that can occur in various medical conditions, including respiratory or cardiac arrest. However, the given statement suggests that cyanosis is not coded specifically with respiratory or cardiac arrest. This means that while cyanosis can be present in these situations, it is not the primary code used to describe them. Other codes would be used to indicate the underlying cause of the arrest, while cyanosis may be mentioned as an associated symptom.

First, the effect (hypertension, syncope, etc)

then the underdosing code

and finally the noncompliance or complication of care code



***Codes for underdosing should never be assigned as principal or

first-listed codes.

The correct answer is "attention to." This suggests that when looking for information about an encounter for gastrostomy tube irrigation, one should search under the keyword "attention to" rather than "gastrostomy tube irrigation." This implies that "attention to" is the more relevant or commonly used term in medical documentation for this type of procedure.

Preemption means to supercede

Post pregnancy hypokalemia is a condition characterized by low levels of potassium in the blood that occurs after childbirth. It is a metabolic disorder that is caused by hormonal changes in the body during the postpartum period. Since it is a metabolic disorder, it should be coded with a nutritional and metabolic disease complicating the puerperium, which falls under the endocrine category. Therefore, the correct answer is endocrine.

Postpartum anemia is always coded. This means that regardless of the circumstances or severity of the anemia, it must always be documented and assigned a code for proper medical record keeping and billing purposes. Anemia after childbirth is a common occurrence due to the loss of blood during delivery, and it is important to track and manage this condition for the well-being of the mother.

Spinal tap is a medical procedure in which a needle is inserted into the lower back to collect cerebrospinal fluid for diagnostic purposes. This procedure is commonly referred to as a diagnostic lumbar puncture, as it is used to diagnose various conditions such as infections, bleeding, or inflammation in the central nervous system.

If a HAC diagnosis is POA it will be classified as CC or MCC and will impact MS-DRG reimbursement by raising the relative weight.